Kim Eui Hyeok, Lee Jaekyung, Lee Sang Ah, Jung Yong Wook
Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, Korea.
Department of Obstetrics and Gynecology, Severance Hospital, Yonsei College of Medicine, Seoul 03722, Korea.
J Clin Med. 2022 Feb 12;11(4):969. doi: 10.3390/jcm11040969.
We aimed to determine the association between maternal age and pregnancy outcomes in singleton primigravidae in South Korea. We reviewed the medical data of singleton primigravidae women who gave birth between 2013 and 2018 and underwent the National Health Screening Examination using the administrative database from the National Health Insurance claims data. As advanced maternal age is associated with various comorbidities that could affect pregnancy outcomes, we divided the patients according to their age and comparatively analyzed the prevalence of high-risk pregnancy complications including rates of cesarean delivery, after adjusting for maternal demographics. Perinatal and postpartum complications according to maternal age were also investigated. Overall, 548,080 women were included in this study: 441,902 were aged <35 years; 85,663, 35-39 years; 20,515, ≥40 years. Patients' demographics differed according to their age. Increasing maternal age was significantly associated with higher income levels and higher rates of obesity, pre-existing diabetes, and hypertension. With the increasing maternal age, the rate of obstetric complications, including gestational diabetes, preeclampsia, placenta previa, placental abruption, and cesarean delivery, increased. Maternal age was also positively correlated with perinatal morbidity including preterm birth and low birth weight. Additionally, advanced maternal age was a risk factor for hospitalization before delivery, more frequent outpatient visits, and readmission after delivery. These observations were maintained in the multivariate analysis results. Advanced maternal age appears to be associated with various adverse obstetric outcomes for primigravidae women, and the frequency of hospitalizations was higher in this group. Considering the current social environment of late pregnancies and childbirth in South Korea, effective policy consideration is required to support safe childbirth in women with advanced maternal age.
我们旨在确定韩国初产妇年龄与单胎妊娠结局之间的关联。我们回顾了2013年至2018年间分娩且使用国民健康保险理赔数据中的行政数据库进行国民健康筛查检查的单胎初产妇的医疗数据。由于高龄产妇与多种可能影响妊娠结局的合并症相关，我们根据年龄对患者进行分组，并在调整产妇人口统计学因素后，比较分析了包括剖宫产率在内的高危妊娠并发症的发生率。我们还调查了根据产妇年龄划分的围产期和产后并发症情况。总体而言，本研究纳入了548,080名女性：441,902名年龄小于35岁；85,663名年龄在35 - 39岁；20,515名年龄大于或等于40岁。患者的人口统计学特征因年龄而异。产妇年龄增加与更高的收入水平、更高的肥胖率、既往糖尿病和高血压发生率显著相关。随着产妇年龄的增加，包括妊娠期糖尿病、先兆子痫、前置胎盘、胎盘早剥和剖宫产在内的产科并发症发生率增加。产妇年龄与包括早产和低出生体重在内的围产期发病率也呈正相关。此外，高龄产妇是分娩前住院、更频繁门诊就诊和产后再入院的危险因素。这些观察结果在多变量分析结果中依然存在。高龄似乎与初产妇的各种不良产科结局相关，且该组住院频率更高。考虑到韩国目前晚育和分娩的社会环境，需要进行有效的政策考量，以支持高龄产妇安全分娩。
